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Saravanan Kasthuri, medical director at Northwest Endovascular Surgery, and Jason McKitrick, executive director at the Office Based Facility Association, discuss their article “Medicare payment is failing rural health.” Saravanan and Jason analyze …
Let me start with a truth many of us sense long before we ever speak it aloud. We whisper it to ourselves on post-call mornings. We feel it in the drive home after another shift that took more than it gave. We carry it into our kitchens, into our bedrooms, and into the quiet moments where no pager or EMR alert can compete with what’s happening inside us.
The elephant in …
A patient with diabetes, hypertension, and obesity comes in for her annual wellness visit. The physician has already spent 20 minutes on chronic disease management and lifestyle guidance. As the visit wraps up, the patient mentions daily heart palpitations that started a month ago.
The exam was benign. The physician has two choices: spend another 20 minutes performing an EKG, discussing differential diagnoses, and developing a workup plan; or refer to …
The pilot of a commercial aircraft, descending into near-zero visibility, hands control to an automated system designed for precisely that moment. The landing is flawless. The passengers are safe. The pilot announces it proudly. Technology functions exactly as promised.
A doctor on board writes, “It made me think about the health care journey I am on with AI. The safety and well-being of 140 people wasn’t left to human intervention; the …
In my first and second KevinMD posts, I emphasized how medicine had failed clinicians by not training them in mental health care. All agree, it’s not our fault. Now let’s look at how successfully our teachers did prepare us for patients with medical disorders. There’s an interesting history behind how we developed expertise in physical diseases: Medicine needed to overthrow the four humors theory that guided clinical care …
President Trump recently made national headlines by calling a female reporter “Piggy,” an act widely decried as outrageous, even for a man who doesn’t shy away from misogyny. It’s one thing to intentionally refer to someone with a derogatory, dismissive label. This kind of behavior should appropriately be met with indignation and moral outrage. But what happens when we carelessly (and repeatedly) call someone a name that belongs to …
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Family physician Tod Stillson discusses his article “Why AI in medicine elevates humanity instead of replacing it.” Tod explains how his career evolution revealed that artificial intelligence is not a threat to …
It has been six months since my robotic-assisted radical prostatectomy, and I find myself suspended in a strange middle space, grateful to be cancer-free, yet still struggling with a question I cannot fully answer: Is it safe for me to restart testosterone replacement therapy?
Before my diagnosis, testosterone replacement was not just a prescription; it was a restoration. I have lived with hypogonadism for years, and TRT helped me regain the …
Most of us don’t notice moral development happening while it is happening. Moral character forms quietly, through repetition, through what we get used to doing and through what we slowly stop doing without much forethought.
Artificial intelligence matters from a moral perspective long before it ever potentially becomes conscious or autonomous. Although AI may or may not confront us with dramatic ethical dilemmas, it does change our moral lives in a …
They are not born into battle.
They arrive with open hands,
with laughter,
with faith that the world will keep them safe.
Yet, men who are not content with peace
clench their fists around power,
mistaking domination for strength
and control for legacy.
They draw borders with bullets
and call it victory.
In their pursuit to prove themselves,
they let the bombs fall.
Roads darken with blood.
Homes become rubble.
The sky learns the language of fire.
And in the wreckage stand the children.
They watch …
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Surgeon and health tech strategist Sarah Matt discusses her article “Why fee-for-service reform is needed.” Sarah analyzes the friction between efficient digital health tools and an outdated payment system that rewards activity …
Somewhere over the last two decades, medicine began to drift into strange territory. Authority (once grounded in evidence, humility, and disciplined expertise) became diluted. Being loud, charismatic, or highly visible somehow became a substitute for scientific credibility.
We’ve long had celebrity doctors, but a new hybrid has emerged: Physicians who are not celebrities in the traditional sense, yet who speak with sweeping certainty far outside their field of training. A neurosurgeon …
Every day, nurses make thousands of clinical decisions that directly shape patient outcomes, safety, and recovery. Yet in many hospitals across the country, these critical choices are still guided by experience-based models rather than current evidence. For a profession that defines itself as patient-centered and science-driven, this approach contradicts the very standard of care we strive to uphold. True excellence in nursing is not defined by technology alone or by …
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A nursing student recently told me she had decided not to apply for bedside roles after graduation. Not because of her clinical rotations. Not because of faculty advice. Because of what she sees every night on TikTok. Her feed is filled with short videos describing unsafe staffing, emotional exhaustion, hostile workplaces, and nurses counting down the days until they can leave the profession. She knows these posts reflect real experiences. …
Eighteen months ago, I learned something every patient hopes never to hear: that my cancer had returned. Years earlier, I had been treated successfully for prostate cancer. When my PSA began to rise again, I knew something was wrong. It took persistence and more than a few second opinions to confirm what my instincts already told me.
That journey eventually led me to a leading cancer center. I had already seen …
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Urologist William Lynes discusses his article “A urologist’s perspective on presidential health transparency.” William examines the medical plausibility of a former president being diagnosed with widespread metastatic prostate cancer just months after …
We repeat the phrase “an ounce of prevention is worth a pound of cure” as if it were a folksy reminder to eat better or get a flu shot. But taken seriously, it is not a medical cliché. It is an economic law. And it exposes a devastating flaw in how modern societies choose to spend money.
Prevention is not the opposite of cure. Cure is essential, lifesaving, and often extraordinary. …
Methamphetamine has become an unavoidable presence in South Texas medicine. It shows up in our EDs, clinics, and ICUs, usually framed as a cardiotoxic, neurotoxic, or psychiatric problem. But over the past few years, a different pattern has kept surfacing in my practice: “pneumonia” cases that don’t behave like pneumonia, young lungs that look like ARDS, and hypoxic patients whose imaging and labs do not match the story, until someone …
Assuming a new health care leadership role is both exciting and daunting. Even in the best circumstances, new leaders must navigate a complex web of expectations, relationships, and organizational priorities.
Drawing on over 30 years of health care leadership experience, we have observed that while new leaders bring enthusiasm and vision, they often encounter predictable obstacles. Many receive little to no formal leadership training, leaving them without a structured approach to …
A patient walks into the pharmacy with a prescription. The pharmacist reviews it, recognizes a serious problem, and contacts the prescriber. The prescriber dismisses the concern. The pharmacist has two choices: dispense a medication they know is wrong, or refuse and risk professional consequences. This happens daily. And health care pretends it doesn’t.
The power imbalance nobody discusses
Pharmacists are trained to be medication experts. They study pharmacokinetics, drug interactions, disease-specific dosing, …
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